Publications by authors named "D Coombs"
Introduction: Patients with musculoskeletal conditions often seek care in an emergency department (ED). The problem is that the time required to manage these patients places an additional pressure on ED physician and nursing staff, who are primarily trained and resourced to manage high-acuity patients. Primary-contact physiotherapists could play a greater role in supporting ED physician and nursing staff in the management of patients presenting to the ED with musculoskeletal conditions.
View Article and Find Full Text PDFEffectiveness of a physiotherapist-led triage and treatment service on WAITing time for adults with musculoskeletal pain referred to Australian public hospital physiotherapy clinics: a protocol for the WAIT-less trial.
BMJ Open
January 2025
Introduction: Musculoskeletal pain is the second leading cause of disease burden in Australia, and there is a need to investigate new models of care to cope with the increasing demand for health services. This paper describes the protocol for a randomised controlled trial investigating whether a physiotherapist-led triage and treatment service is non-inferior for improving function at 6 months and superior for reducing treatment waiting times, compared with usual care for patients with musculoskeletal pain referred to public hospital outpatient physiotherapy clinics.
Methods And Analysis: A total of 368 participants (184 per arm) will be recruited from six public hospitals located in metropolitan Sydney, Australia.
Article Synopsis
- The study aimed to evaluate the occurrence of extra-musculoskeletal manifestations (EMMs) in patients with psoriatic arthritis (PsA) or axial spondyloarthritis (axSpA) treated with a specific medication, upadacitinib (UPA15).
- Data from five clinical trials were analyzed to compare adverse events like uveitis and inflammatory bowel disease (IBD) among patients receiving either UPA15, a placebo, or adalimumab (ADA).
- Results showed that most patients did not have a history of EMMs, and the occurrence of uveitis and IBD was generally low, particularly in those treated with UPA15 compared to the placebo.
Objectives: Low back pain was the sixth most common reason for an ED visit in 2022-2023 in Australia, one-third of these patients were subsequently admitted to hospital. Therefore, we have assessed whether some patients could be diverted to alternate clinical pathways, via admission to a virtual hospital (rpavirtual), and be cared for remotely in their own homes.
Methods: Ethics approval was granted for protocols X21-0278 & 2021/ETH10967 and X21-0094 & 2021/ETH00591.